Healthcare Provider Details

I. General information

NPI: 1780118737
Provider Name (Legal Business Name): NASIR KHATRI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2017
Last Update Date: 04/18/2025
Certification Date: 04/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 S SAGINAW ST
FLINT MI
48507-2677
US

IV. Provider business mailing address

4800 S SAGINAW ST
FLINT MI
48507-2677
US

V. Phone/Fax

Practice location:
  • Phone: 810-275-9333
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number4301510315
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number4301510315
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: